NCLEX Endo

The client with pheochromocytoma is scheduled for surgery and says to the nurse, "I'm not sure that surgery is the best thing to do." Which statement is the appropriate response by the nurse?

"You have concerns about the surgical treatment for your condition?"

The clinic nurse is providing instructions to a client with diabetes mellitus about the signs and symptoms of hypoglycemia. The nurse would tell the client that which would be noted in a hypoglycemic reaction?

Hunger

A client with hypovolemia experiences activation of the renin-angiotensin system to maintain blood pressure. The registered nurse determines that the new nurse understands that what substance is secreted if which statement is made?

"Aldosterone will be secreted."

A client with diabetes mellitus who takes insulin is seen in the health care clinic. The client tells the clinic nurse that after the insulin injection, the insulin seems to leak through the skin. The nurse would appropriately determine the problem by asking the client which question?

"Are you rotating the injection site?"

The nurse is caring for a client scheduled for a transsphenoidal hypophysectomy. The preoperative teaching instructions would include which statement?

"Brushing your teeth needs to be avoided for at least 2 weeks after surgery."

The nurse is instructing a client with Cushing's syndrome on follow-up care. Which of these client statements would indicate a need for further instruction?

"I need to avoid foods high in potassium."

The home care nurse visits a client with a diagnosis of hyperparathyroidism who is taking furosemide and provides dietary instructions to the client. Which statement by the client indicates a need for additional instruction?

"I need to increase my intake of dietary items that are high in calcium."

The nurse is caring for a client who is scheduled to have a thyroidectomy and provides instructions to the client about the surgical procedure. Which client statement indicates an understanding of the nurse's instructions?

"I need to place my hands behind my neck when I have to cough or change positions."

The nurse provides dietary instructions to a client with diabetes mellitus regarding the prescribed diet. Which statement, if made by the client, indicates a need for further teaching?

"I need to purchase special diabetic foods."

A nurse is providing home care instructions to a client with a diagnosis of Addison's disease. Which statement by the client indicates a need for further instruction?

"I will need to take daily medications until my symptoms decrease."

The nurse provides instructions to a client newly diagnosed with type 1 diabetes mellitus about measures to take if feeling sick to prevent diabetic ketoacidosis (DKA). The nurse recognizes accurate understanding of measures to prevent DKA when the client makes which statement?

"I will notify my primary health care provider (PHCP) if my blood glucose level is higher than 250 mg/dL (13.9 mmol/L)."

A client has been hospitalized for an endocrine system dysfunction of the pancreas. The registered nurse asks the new orientee nurse what kind of problem a client hospitalized for endocrine dysfunction of the pancreas would expect. The new orientee nurse demonstrates understanding if which statement is made?

"Insulin production will be decreased."

A client newly diagnosed with diabetes mellitus is instructed by the primary health care provider to obtain glucagon for emergency home use. The client asks a home care nurse about the purpose of the medication. What is the nurse's best response to the client's question?

"It is for the times when your blood glucose is too low from too much insulin."

A client with type 1 diabetes mellitus is having trouble remembering the types, duration, and onset of the action of insulin. The client tells the nurse that family members have not been supportive. Which response by the nurse is best?

"Let me go over the types of insulins with you again."

The nurse is providing education to a client with type 2 diabetes mellitus. The nurse explains in layperson's language the physiological mechanism behind hypoglycemia. Which response by the client determines that teaching has been successful?

"My body increases glucagon production to fight low blood sugars."

A client with diabetes mellitus has been instructed in the dietary exchange system. The client asks the nurse if bacon is allowed in the diet. Which nursing response is most appropriate?

"One strip of bacon may be eaten if you eliminate 1 teaspoon of butter."

The nurse is interviewing a client with type 2 diabetes mellitus who is taking a sulfonylurea. Which statement by the client indicates an understanding of this treatment for this disorder?

"The medications I'm taking help release the insulin I already make."

The nurse is caring for a client with Addison's disease. The client asks the nurse about the risks associated with this disease, specifically about addisonian crisis. Regarding prevention of this complication, how would the nurse inform the client?

"You need to increase salt in your diet, particularly during stressful situations."

The nurse is caring for a client diagnosed with type 1 diabetes mellitus experiencing the Somogyi effect. Which blood glucose results and treatment would the nurse expect?

0300 blood glucose 68 mg/dL (3.8 mmol/L) and 0700 blood glucose 200 mg/dL (11.1 mmol/L). Instruct to decrease amount of evening insulin.

The nurse is caring for a client who had a transsphenoidal hypophysectomy. Which statements would the nurse include in the discharge teaching instructions? Select all that apply.

1"Include adequate fiber and fluids in your diet." 2"Wear slip-on shoes rather than those that need to be tied." 4"Brushing your teeth will not be permitted for at least 2 weeks after surgery. "5"Contact your primary health care provider immediately if you develop any headache, fever, or neck stiffness."

The nurse caring for a client newly admitted to the hospital who is at risk for diabetes mellitus suspects that the client has metabolic syndrome if which characteristics have been identified in this client? Select all that apply.

1Hemoglobin A1C of 6.5% 3Triglycerides 160 mg/dL (1.81 mmol/L) 5Serial fasting glucose levels of 120 mg/dL (6.85 mmol/L), 132 mg/dL (7.54 mmol/L), and 128 mg/dL (7.31 mmol/L)

A client with a diagnosis of addisonian crisis is being admitted to the intensive care unit. Which findings will the interprofessional health care team focus on? Select all that apply.

1Hypotension 3Hyperkalemia

The nurse is admitting a client who is diagnosed with syndrome of inappropriate antidiuretic hormone secretion (SIADH) and has serum sodium of 118 mEq/L (118 mmol/L). Which prescriptions would the nurse anticipate receiving? Select all that apply.

1Initiate an infusion of 3% NaCl. .3Restrict fluids to 800 mL over 24 hours. 5Administer a vasopressin antagonist as prescribed.

A nursing instructor is teaching the class about Addison's disease. The instructor determines that the class understands the disease process if they indicate which are affected in this disease? Select all that apply.

1Androgens 4Glucocorticoids 5Mineralocorticoids

The nurse is admitting a client who is diagnosed with syndrome of inappropriate antidiuretic hormone secretion (SIADH) and has serum sodium of 118 mEq/L (118 mmol/L). Which primary health care provider prescriptions would the nurse anticipate receiving? Select all that apply.

1Initiate an infusion of 3% NaCl. 3Restrict fluids to 800 mL over 24 hours. 5Administer a vasopressin antagonist as prescribed.

A client is hospitalized with a diagnosis of adrenal insufficiency. Which findings does the nurse identify as supportive of this diagnosis? Select all that apply.

1Irritability 2Complaints of nausea 3Sodium level of 128 mEq/L (128 mmol/L) 5Blood pressure lying 138/70 mm Hg and standing 110/58 mm Hg

A client with a recent history of total thyroidectomy has developed iatrogenic hypoparathyroidism. Which observed findings does the nurse determine are associated with the hypoparathyroidism? Select all that apply.

1Laryngospasm 4Positive Chvostek's sign 5Positive Trousseau's sign

The nurse is developing a plan of care for a client with Addison's disease. The nurse has identified a problem of risk for deficient fluid volume and identifies nursing interventions that will prevent this occurrence. Which nursing interventions would the nurse include in the plan of care? Select all that apply.

1Monitor for changes in mentation. 4Encourage fluid intake of at least 3000 mL per day. 5Monitor vital signs, skin turgor, and intake and output.

The nurse is caring for a client with a diagnosis of diabetic ketoacidosis (DKA). Which assessment findings are consistent with this diagnosis? Select all that apply.

1Polyuria 2Polydipsia 3Polyphagia 4Dry mouth 5Flushed, dry skin

The nurse is completing an assessment on a client who is being admitted for a diagnostic workup for primary hyperparathyroidism. Which client complaints would be characteristic of this disorder? Select all that apply.

1Polyuria 3Bone pain

The nurse teaches a client with diabetes mellitus about differentiating between hypoglycemia and ketoacidosis. The client demonstrates an understanding of the teaching by stating that a form of glucose would be taken if which symptom or symptoms develop? Select all that apply.

2Shakiness 3Palpitations 5Light-headedness

The nurse would include which interventions in the plan of care for a client with hypothyroidism? Select all that apply.

3Instruct the client about thyroid replacement therapy. 4Encourage the client to consume fluids and high-fiber foods in the diet. .6Instruct the client to contact the primary health care provider (PHCP) if episodes of chest pain occur.

The nurse would include which interventions in the plan of care for a client with hyperthyroidism? Select all that apply.

3A thyroid-releasing inhibitor will be prescribed. 4Encourage the client to consume a well-balanced diet.

A nurse is reviewing the assessment findings and laboratory data for a client with the syndrome of inappropriate antidiuretic hormone secretion (SIADH). The nurse understands that which symptoms are associated characteristics of this disorder? Select all that apply.

3High urine osmolality 4Low serum osmolality 5Hypotonicity of body fluids 6Continued release of antidiuretic hormone (ADH)

The nurse is preparing to care for a client after parathyroidectomy. The nurse would plan for which action for this client?

Administer a continuous mist of room air or oxygen.

The nurse is caring for a client admitted to the emergency department with diabetic ketoacidosis (DKA). In the acute phase, the nurse plans for which priority intervention?

Administer short-duration insulin intravenously.

A 33-year-old client is admitted to the hospital with a tentative diagnosis of Graves' disease. Which symptom related to the menstrual cycle would the client be most likely to report during the initial assessment?

Amenorrhea

The nurse is assessing a client who has a diagnosis of goiter. Which would the nurse expect to note during the assessment of the client?

An enlarged thyroid gland

The nurse is reviewing the primary health care provider's (PHCP's) prescriptions for a client with a diagnosis of diabetes mellitus who has been hospitalized for treatment of an infected foot ulcer. The nurse expects to note which finding in the PHCP's prescriptions?

An increased amount of NPH insulin daily

A client has been hospitalized for impaired function of the posterior pituitary gland. The nurse plans to monitor for signs and symptoms of which hormone imbalance?

Antidiuretic hormone (ADH)

The nurse is reviewing the postoperative prescriptions for a client who had a transsphenoidal hypophysectomy. Which prescription, if noted on the record, would indicate the need for clarification?

Apply a loose dressing if any clear drainage is noted.

After hypophysectomy, a client complains of being thirsty and having to urinate frequently. What is the initial nursing action?

Assess urine specific gravity.

The nurse is caring for a client with a serum phosphorus level of 5.0 mg/dL (1.61 mmol/L). What other laboratory value might the nurse expect to note in the medical record?

Calcium level of 8 mg/dL (2.0 mmol/L)

A home health nurse is visiting a client with type 1 diabetes mellitus. The client states to the nurse "I am not feeling well and had a respiratory problem for the past week, which seems to be getting worse." After interviewing the client, what would be the initial nursing action?

Check the client's blood glucose.

A client visits the primary health care provider's office for a routine physical examination and reports a new onset of intolerance to cold. Since hypothyroidism is suspected, which additional information would be noted during the client's assessment?

Complaints of weakness and lethargy

A client who visits the primary health care provider's office for a routine physical examination reports new onset of intolerance to cold. Knowing that this is a frequent complaint associated with hypothyroidism, the nurse would check for which manifestations?

Complaints of weakness and lethargy

A client with diabetes mellitus demonstrates acute anxiety when admitted to the hospital for the treatment of hyperglycemia. What is the appropriate intervention to decrease the client's anxiety?

Convey empathy, trust, and respect toward the client.

A client is diagnosed with Cushing's syndrome. When reviewing the recent laboratory results, the nurse would expect an excess of which substance?

Cortisol

A nurse is caring for a client who had a thyroidectomy 1 day ago. Which client laboratory data would the nurse identify as a possible complication of thyroid surgery?

Decreased serum calcium level

The nurse is performing an assessment on a client with a diagnosis of myxedema (hypothyroidism). Which assessment finding would the nurse expect to note in this client?

Dry skin

The nurse is providing dietary instructions to help with diabetes control for a client newly diagnosed with diabetes mellitus who will be taking insulin. The nurse would provide the client with which best instruction?

Eat meals at approximately the same time each day.

A client with a history of diabetes mellitus has a fingerstick blood glucose level of 460 mg/dL (25.6 mmol/L). The home care nurse anticipates that which additional finding would be present with further testing if the client is experiencing diabetic ketoacidosis (DKA)?

Elevated serum ketones

The nurse has documented the problem of body image distortion for a client with a diagnosis of Cushing's syndrome. The nurse identifies nursing interventions related to this problem and includes these interventions in the plan of care. Which nursing intervention is inappropriate?

Encourage the client to recognize that the body changes need to be dealt with.

A client arrives in the hospital emergency department in an unconscious state. As reported by the spouse, the client has diabetes mellitus and began to show symptoms of hypoglycemia. A blood glucose level is obtained for the client, and the result is 40 mg/dL (2.28 mmol/L). Which medication would the nurse anticipate will be prescribed for the client?

Glucagon

A hospitalized client is experiencing an episode of hypoglycemia. The client is lethargic and has no available intravenous (IV) access. Which medication would the nurse anticipate administering?

Glucagon

A client with type 2 diabetes mellitus has a blood glucose level greater than 600 mg/dL (34.3 mmol/L) and is complaining of polydipsia, polyuria, weight loss, and weakness. The nurse reviews the primary health care provider's documentation and expects to note which diagnosis?

Hyperosmolar hyperglycemic syndrome (HHS)

A client with type 2 diabetes mellitus is complaining of polydipsia, polyuria, weight loss, and weakness. Laboratory results indicate a blood glucose level of 800 mg/dL (45.7 mmol/L) and nonketosis. The nurse reviews the primary health care provider's documentation and expects to note which diagnosis?

Hyperosmolar hyperglycemic syndrome (HHS)

A client has been diagnosed with pheochromocytoma. Which clinical manifestation is most indicative of this condition?

Hypertension

The nurse is reviewing the record of a client admitted to the hospital with a diagnosis of pheochromocytoma. The nurse reads the assessment findings and expects to note documentation of which major symptom associated with this condition?

Hypertension

A client is admitted to the hospital with a diagnosis of Addison's disease. The nurse would assess for which problem as a manifestation of this disorder?

Hypotension

A client is admitted to a hospital with a diagnosis of diabetic ketoacidosis (DKA). The initial blood glucose level is 950 mg/dL (54.2 mmol/L). A continuous intravenous (IV) infusion of short-acting insulin is initiated, along with IV rehydration with normal saline. The serum glucose level is now decreased to 240 mg/dL (13.7 mmol/L). The nurse would next prepare to administer which medication?

IV fluids containing dextrose

What information stated by a nursing student about the 15/15 rule for treating a hypoglycemic reaction indicates an understanding of the rule?

If my client's blood glucose is below 70 mg/dL (3.9 mmol/L), I will give 15 g of juice and recheck blood glucose in 15 minutes.

The nurse is preparing a plan of care for a client with diabetes mellitus who has hyperglycemia. The nurse places priority on which client problem?

Inadequate fluid volume

A client has abnormal amounts of circulating thyronine (T3) and thyroxine (T4). While obtaining the health history, the nurse asks the client about dietary intake. Lack of which dietary element is most likely the cause?

Iodine

The nurse is caring for a client after thyroidectomy. The client expresses concern about the postoperative voice hoarseness she is experiencing and asks if the hoarseness will subside. The nurse would provide the client with which information?

It is normal during this time and will subside.

A client with diabetes mellitus is at risk for a serious metabolic disorder from the breakdown of fats for conversion to glucose. The nurse would anticipate that which substance will be elevated?

Ketones

A client is admitted with a serum glucose level of 650 mg/dL (37.14 mmol/L), and diabetic ketoacidosis (DKA) is suspected. Which additional laboratory result does the nurse identify as being supportive of DKA?

Ketones in urine

The nurse is caring for a client who is 2 days postoperative from abdominal hysterectomy. The client has a history of diabetes mellitus and has been receiving regular insulin based on capillary blood glucose testing 4 times a day. A carbohydrate-controlled diet has been prescribed, but the client has not been eating. On entering the client's room, the nurse finds the client to be pale and diaphoretic. Which action is appropriate at this time?

Obtain a capillary blood glucose level and quickly perform a focused assessment.

A nurse is assessing a client who has had cranial surgery and is at risk for development of diabetes insipidus. The nurse would assess for which signs or symptoms that could indicate development of this complication?

Polydipsia

The nurse is monitoring a client newly diagnosed with diabetes mellitus for signs of complications. Which sign or symptom, if frequently exhibited in the client, indicates that the client is at risk for chronic complications of diabetes if the blood glucose is not adequately managed?

Polyuria

The nurse caring for a client with a diagnosis of hypoparathyroidism reviews the laboratory results of blood tests for this client and notes that the calcium level is extremely low. The nurse would expect to note which finding on assessment of the client?

Positive Trousseau's sign

A primary health care provider has prescribed methimazole for a client with hyperthyroidism. The nurse would question the client about which of the following that is a contraindication to the use of this treatment?

Pregnancy

A client with type 1 diabetes mellitus is admitted to the emergency department with suspected diabetic ketoacidosis (DKA). Which laboratory result would be expected with this diagnosis?

Serum potassium is 6.8 mEq/L (6.8 mmol/L).

During health history taking, the client complains of weight loss and diarrhea and says "I can feel my heart beating in my chest." The nurse anticipates that which diagnostic test will most likely be prescribed by the primary health care provider (PHCP) in order to determine the underlying condition leading to the client's signs and symptoms?

Serum thyroid-stimulating hormone (TSH)

A client's serum blood glucose level is 48 mg/dL (2.74 mmol/L). The nurse would expect to note which as an additional finding when assessing this client?

Slurred speech

A nurse is performing an admission assessment on a client with a diagnosis of pheochromocytoma. The nurse would assess for the major sign associated with pheochromocytoma by performing which action?

Taking the client's blood pressure

The nurse is caring for a client after thyroidectomy. The nurse notes that calcium gluconate is prescribed for the client. The nurse determines that this medication has been prescribed for which purpose?

To treat hypocalcemic tetany

The nurse is preparing for a client's postoperative return to the unit after a parathyroidectomy procedure. The nurse would ensure that which piece of medical equipment is at the client's bedside?

Tracheotomy set

A client has been diagnosed with Cushing's syndrome. The nurse would assess the client for which expected manifestations of this disorder?

Truncal obesity

A client newly diagnosed with diabetes mellitus is started on multiple-component insulin therapy and will receive a two-dose insulin protocol combination of short- and intermediate-acting insulin injected twice daily. What portion of the total dose is given before breakfast, and what portion is given before the evening meal?

Two thirds before breakfast and one third before the evening meal

During routine nursing assessment after hypophysectomy, a client complains of thirst and frequent urination. Knowing the expected complications of this surgery, what would the nurse assess next?

Urine specific gravity

The nurse has provided dietary instructions to a client with a diagnosis of hypoparathyroidism. The nurse would instruct the client that it is acceptable to include which item in the diet?

Vegetables

A preoperative client is scheduled for adrenalectomy to remove a pheochromocytoma. The nurse would most appropriately monitor which item in the preoperative period?

Vital signs

The nurse is caring for a client with pheochromocytoma who is scheduled for adrenalectomy. In the preoperative period, what would the nurse monitor as the priority?

Vital signs

The home health nurse visits a client with a diagnosis of type 1 diabetes mellitus. The client reports a history of vomiting and diarrhea and tells the nurse that no food has been consumed for the last 24 hours. Which additional statement by the client indicates a need for further teaching?

"I need to stop my insulin."

The home care nurse is visiting a client newly diagnosed with diabetes mellitus. The client tells the nurse about planning to eat dinner at a local restaurant this week. The client asks the nurse whether eating at a restaurant will affect diabetic control and whether this is allowed. Which nursing response is most appropriate?

"You could order a half-portion meal and have fresh fruit for dessert."

A client received 5 units of insulin aspart subcutaneously just before eating lunch at 12:00 p.m. The nurse would assess the client for a hypoglycemic reaction at which times?

Between 1:00 and 3:00 p.m.

The emergency department nurse is reviewing the laboratory test results for a client suspected of having diabetic ketoacidosis (DKA). Which laboratory result would the nurse expect to note in this disorder?

Blood glucose level of 500 mg/dL (28.5 mmol/L)

A client is admitted to the hospital with a diagnosis of pheochromocytoma. The nurse would check which item to detect the primary manifestation of this disorder?

Blood pressure

The nurse in a health care clinic is reviewing the record of a client with diabetes mellitus who was just seen by the primary health care provider (PHCP). The nurse notes that the PHCP has prescribed acarbose. Which preexisting disorder, if noted in the client's record, would indicate a contraindication to the use of this medication?

Renal insufficiency

The nurse is caring for a client after hypophysectomy and notes clear nasal drainage from the client's nostril. The nurse would take which initial action?

Test the drainage for glucose.

The nurse has provided instructions for measuring blood glucose levels to a client newly diagnosed with diabetes mellitus who will be taking insulin. The client demonstrates understanding of the instructions by identifying which method as the best method for monitoring blood glucose levels?

"I will check my blood glucose level before each meal and at bedtime."

The family of a bedridden client with type 2 diabetes mellitus and chronic kidney disease calls the nurse to report symptoms of headache, polydipsia, and increased lethargy. Which most important question would the nurse ask the family to determine a possible problem?

"What is the client's capillary blood glucose level?"

The nurse is monitoring a client who was diagnosed with type 1 diabetes mellitus and is being treated with NPH and regular insulin. Which manifestations would alert the nurse to the presence of a possible hypoglycemic reaction? Select all that apply.

1Tremors 3Irritability 4Nervousness

A hospitalized client is diagnosed with type 1 diabetes mellitus. The nurse plans care for the client, understanding that which factors are likely causes of the beta cell destruction that accompanies this disorder? Select all that apply.

1Viruses 2Genetic factors 3Autoimmune factors 4Human leukocyte antigen (HLA)

The nurse teaches a class on foot care for clients diagnosed with diabetes mellitus. Which instructions would the nurse include in the class? Select all that apply.

1Wear closed-toe shoes. 4Cut toenails straight across and file the edges. 5Pat feet dry gently, especially between the toes.

The nurse is assessing the learning readiness of a client newly diagnosed with diabetes mellitus. Which behavior indicates to the nurse that the client is not ready to learn?

The client complains of fatigue whenever the nurse plans a teaching session.

A client has just been admitted to the nursing unit following thyroidectomy. Which assessment is the priority for this client?

Audible stridor

The nurse is monitoring a diabetic client with a blood glucose level of 400 mg/dL (22.2 mmol/L). Which clinical manifestation would indicate diabetic ketoacidosis (DKA)?

Rapid, deep respirations

The nurse is caring for a client admitted to the hospital with uncontrolled type 1 diabetes mellitus. In the event that diabetic ketoacidosis (DKA) does occur, the nurse anticipates that which medication would most likely be prescribed?

Regular insulin